Maternal use of selective serotonin re‐uptake inhibitors and persistent pulmonary hypertension of the newborn

Pharmacoepidemiology and Drug Safety (Impact Factor: 2.9). 07/2008; 17(8):801 - 806. DOI: 10.1002/pds.1570

ABSTRACT In order to evaluate the previously published association between maternal use of selective serotonin re-uptake inhibitors (SSRI) and persistent pulmonary hypertension in the neonate (PPHN), we used data from the Swedish Medical Birth Register for the years 1997–2005. Infants were identified from discharge diagnoses, and maternal exposure to drugs from interviews performed in early pregnancy and from prescriptions from the antenatal care service. Putative confounders were studied: an increased risk for PPHN was indicated for high maternal age, for first parity, for maternal BMI, and possibly for maternal smoking. Adjusting for these variables and year of birth, an association between maternal use of SSRI and PPHN in births after 34 completed weeks was identified with a risk ratio of 2.4, 95%CI 1.2–4.3 when based on women who reported the drug use in early pregnancy. When a subgroup of the women were studied who also had prescriptions for SSRI from the antenatal care later in pregnancy, the risk estimate was 3.6, 95%CI 1.2–8.3. The risk estimates were lower than that described previously in the literature, but both estimates could come from the same about 4–5 times increased risk. The mechanism behind the association between SSRI and PPHN is unclear but an increased risk for respiratory problems after maternal use of SSRI is well known, and PPHN could be a rare part of this association. Copyright © 2008 John Wiley & Sons, Ltd.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Medicin Serotonin genoptagshaemmere (SRI) omfatter: Selektive serotonin genoptagshaemmere (SSRI): Fluoxetin (f.eks. Fontex®) Citalopram (f.eks. Cipramil®) Paroxetin (f.eks. Seroxat®) Sertralin (f.eks. Zoloft®) Serotonin noradrenalin genoptagshaemmere (SNRI): Venlafaxin (f.eks. Efexor®) Duloxetin (Cymbalta®) Escitalopram (f.eks. Cipralex®) Fluvoxamin (Fevarin®) GENERELT Disse praeparater anvendes bl.a. til behandling af angsttilstande, depression og obsessiv-compulsiv tilstand. For nemheds skyld betegnes disse sygdomme "grundsygdommen" i det følgende. Risikoen og usikkerheden ved brug af disse praeparater skal vejes op mod den vaesentlige risiko en af de naevnte sygdomme ubehandlet kan udgøre for mor og barn under og efter graviditeten. Seponering under og efter graviditeten er desuden forbundet med en betydelig øget risiko for tilbagefald. • Ordination og kontrol af patientens behandling bør ske i samarbejde med speciallaege i psykiatri (C). På grund af tvivl om praeparaterne sikkerhed bør behandling bør vaere velindiceret og bør revurderes under graviditeten (C). Seponering af behandling bør ske i samarbejde mellem psykiater og praktiserende laege, under hensyntagen til patientens aktuelle symptomatologi samt anamnestiske forhold. • Hensynet til kvindens grundsygdom kan nødvendiggøre behandling med praeparater, der enten ikke er undersøgte eller som vurderes mindre sikre (C).
  • [Show abstract] [Hide abstract]
    ABSTRACT: Perinatal depression affects 10–20% of women and has wide‐ranging consequences for the mothers and their families. Although antidepressant medications are widely used to treat depression, many perinatal women express interest in alternative treatment options. Physical activity interventions may be particularly useful in perinatal populations given high rates of physical inactivity and the potential benefits associated with physical activity. We review research addressing the relationship between physical activity and mood across the perinatal period, with an emphasis on both naturalistic and intervention research. Evidence indicates that physical activity interventions may be an effective intervention for perinatal depression, but rigorous randomized controlled trials are needed to determine the efficacy of these interventions. We conclude with recommendations for future research in this area.
    Clinical Psychology Science and Practice 03/2012; 19(1). · 2.92 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The effects of antenatal depression and antidepressant treatment during pregnancy on both mother and child are vigorously studied, but the underlying biology for these effects is largely unknown. The placenta plays a crucial role in the growth and development of the fetus. We performed a gene expression study on the fetal side of the placenta to investigate gene expression patterns in mothers with antenatal depression and in mothers using antidepressant treatment during pregnancy. Placental samples from mothers with normal pregnancies, from mothers with antenatal depression, and from mothers using antidepressants were collected. We performed a pilot microarray study to investigate alterations in the gene expression and selected several genes from the microarray for biological validation with qPCR in a larger sample. In mothers with antenatal depression 108 genes were differentially expressed, whereas 109 genes were differentially expressed in those using antidepressants. Validation of the microarray revealed more robust gene expression differences in the seven genes picked for confirmation in antidepressant-treated women than in depressed women. Among the genes that were validated ROCK2 and C12orf39 were differentially expressed in both depressed and antidepressant-treated women, whereas ROCK1, GCC2, KTN1, and DNM1L were only differentially expressed in the antidepressant-treated women. In conclusion, antenatal depression and antidepressant exposure during pregnancy are associated with altered gene expression in the placenta. Findings on those genes picked for validation were more robust among antidepressant-treated women than in depressed women, possibly due to the fact that depression is a multifactorial condition with varying degrees of endocrine disruption. It remains to be established whether the alterations found in the gene expression of the placenta are found in the fetus as well.
    Frontiers in Cellular Neuroscience 01/2014; 8:465. · 4.18 Impact Factor